The President’s records

When it was announced that both the presidential candidates were allowing sight of medical information about them to be read and reported on by journalists, I was slightly perturbed. Sure, I could see that perhaps the knowledge that one had no outstanding concerns with their health might – might – have some kind of relevance to an election.

But not really. First of all, while we can say that we are fine “at the moment” who knows what may be around the corner? Not everyone has risk factors for the illnesses that they will later die of. Medical “check-ups” are seriously limited in their abilities to offer a prognosis of any value. And in the case of a declaration of illness, disease or even risk factors for disease, how then can an electorate fairly decide if this will affect the ability to hold office? Many illnesses or disabilities need nothing more than the correct type of support or treatment. The real problem with the declaration of some health issues is not so much the disability that this may or may not reveal, but the disability that the public may imagine.

Lord Owen thinks we should be borrowing pages from the US book. He writes in the British Medical Journal this week: “Everyone who wishes to put themselves forward to the electorate as a potential national leader ought to be compelled by party rules to submit to an independent health examination that doesn’t involve their personal doctors and that is assessed by people of proven independence. This would not run into conflict with any existing legislation protecting the rights of the individual. If potential candidates knew they faced independent assessment and that they had a health problem then either they would not stand or they would make it public of their own volition. For example, John Kennedy, in 1960, believed that he would never be elected president if he admitted he had severe Addison’s disease. Yet there is no reason why someone who has Addison’s disease should not be US president if it is well controlled with replacement therapy.”

This is contradictory, unfair, and oppositional to the tenet that doctors should be first an advocate for the patient, and capable of a confidential professional relationship with them. Why on earth should JFK have “admitted” (in itself a pejorative term) to a condition which Owen rightly says need have had no impact on his abilities in office?

Owen also brings up the issue of Tony Blair and his heart irregularity which he says was not, as was contemporaneously reported, a new issue, but an old one.  “I do not believe it is in the public interest that this situation be allowed to continue,” Owen writes, wishing all this information to be placed in the public domain. But these type of heart rhythms are common, and readily treatable, and I can think of no reason why this should stop someone from being PM. What is the point of the public knowing about it? None. It is personal information, and even world leaders are entitled to have privacy.

So what kind of health problem should stop people declaring themselves a potential leader? I know people with metastatic cancer who have stable health, and who are also insightful and thoughtful. I know people who have major mental illness who are not only capable but who work in partnership with health professionals such that they can remain insightful and well. I know people with heart disease who have not stopped from being the same impressive businesspeople that they always were. Nor would I wish to restrict the groups of people who would hope to lead the country to those who are happy for their medical records to be laid bare. This introduces a dangerous bias. Egotism, overconfidence and irrationality are the qualities I most fear in politicians, and none of these are medical conditions.

I am taking a break from the blog for a week or two and will catch up then. 

Margaret McCartney’s Blog

This blog is no longer updated but it remains open as an archive.

A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

FT Blogs